Molecular mechanisms and cellular process in signal transduction pathway related to air pollutants in obstructive lung diseases:A mini-review

Exposure to air pollutants such as PM_(10),PM_(2.5),PM_(0.1),O_(3),CO,NO2,and SO_(2),and biological pollutants are important factors causing the evolution and furtherance of obstructive lung diseases(OLD),including asthma and chronic obstructive pulmonary disease(COPD).Asthma is the most frequent chronic inflammatory airway disease,characterized by breathlessness,wheezing,chest tightness,and cough,together with the presence of exaggerated expiratory airflow fluctuation that varies over time.COPD is a heterogeneous lung condition characterized by chronic respiratory symptoms such as dyspnea,cough,expectoration,and/or exacerbations due to abnormalities of the airways and/or alveoli that cause persistent,often progressive,airflow obstruction.Understanding the molecular mechanisms and cellular processes based on the development of OLD on exposure to air pollutants will provide insights into the solution of pathogenesis,prevention,and treatment of these conditions.The molecular mechanisms and cellular process involved in signal transduction pathway plays a role in the binding of extracellular signaling molecules and ligands to receptors placed on the cell surface or on the inner side cell that trigger inflammation that occurs,especially when something important enters the cell to bring into a cascade response.This binding then alters the cell metabolism,shape,and gene expression in the airway.This review aimed to reveal the effect of air pollutants on the molecular mechanisms and cellular processes involved in the signal transduction pathways in OLD.

Non-Invasive Early Diagnosis of Obstructive Lung Diseases Leveraging Machine Learning Algorithms

Lungs are a vital human body organ,and different Obstructive Lung Diseases(OLD)such as asthma,bronchitis,or lung cancer are caused by shortcomings within the lungs.Therefore,early diagnosis of OLD is crucial for such patients suffering from OLD since,after early diagnosis,breathing exercises and medical precautions can effectively improve their health state.A secure non-invasive early diagnosis of OLD is a primordial need,and in this context,digital image processing supported by Artificial Intelligence(AI)techniques is reliable and widely used in the medical field,especially for improving early disease diagnosis.Hence,this article presents an AIbased non-invasive and secured diagnosis for OLD using physiological and iris features.This research work implements different machine-learning-based techniques which classify various subjects,which are healthy and effective patients.The iris features include gray-level run-length matrix-based features,gray-level co-occurrence matrix,and statistical features.These features are extracted from iris images.Additionally,ten different classifiers and voting techniques,including hard and soft voting,are implemented and tested,and their performances are evaluated using several parameters,which are precision,accuracy,specificity,F-score,and sensitivity.Based on the statistical analysis,it is concluded that the proposed approach offers promising techniques for the non-invasive early diagnosis of OLD with an accuracy of 97.6%.

Anti-inflammatory effects of Tao Hong Si Wu Tang in mice with lung cancer and chronic obstructive pulmonary disease

BACKGROUND Lung cancer(LC)combined with chronic obstructive pulmonary disease(COPD)is a common combination of comorbidities.Anti-inflammation and modulation of oxidative/antioxidative imbalance may prevent COPD-induced LC,and are also crucial to the treatment of LC combined with COPD.Modern studies have shown that Tao Hong Si Wu Tang(THSW)has vasodilatory,anti-inflammatory,anti-fatigue,anti-shock,immunoregulatory,lipid-reducing,micronutrient-supplementing,and anti-allergy effects.AIM To observe the effects of THSW on COPD and LC in mice.METHODS A total of 100 specific pathogen-free C57/BL6 mice were randomly divided into five groups:Blank control group(group A),model control group(group B),THSW group(group C),IL-6 group(group D),and THSW+IL-6 group(group E),with 20 mice in each group.A COPD mouse model was established using fumigation plus lipopolysaccharide intra-airway drip,and an LC model was replicated by in situ inoculation using the Lewis cell method.RESULTS The blank control group exhibited a clear alveolar structure.The model control and IL-6 groups had thickened alveolar walls,with smaller alveolar lumens,interstitial edema,and several inflammatory infiltrating cells.Histopathological changes in the lungs of the THSW and THSW+IL-6 groups were less than those of the model control group.The serum IL-1β,IL-6,and TNF-αlevels and IL-6R,JAK,p-JAK,STAT1/3,p-STAT1/3,FOXO,p-FOXO,and IL-7R expression levels in lung tissues of mice in the rest of the groups were significantly higher than those of the blank control group(P<0.01).Compared with the model control group,the IL-6 group demonstrated significantly higher levels for the abovementioned proteins in the serum and lung tissues(P<0.01),and the THSW group had significantly higher serum IL-1β,IL-6,and TNF-αlevels and IL-7R expression levels in lung tissues(P<0.01)but significantly decreased IL-6R,JAK,p-JAK,STAT1/3,p-STAT1/3,FOXO,p-FOXO,and IL-7R levels(P<0.01).CONCLUSION THSW reduces the serum IL-1β,IL-6,and TNF-αlevels in the mouse model with anti-inflammatory effects.Its antiinflammatory mechanism lies in inhibiting the overactivation of the JAK/STAT1/3 signaling pathway.

Research progress of red blood cell distribution width in diagnosis and treatment of lung diseases and prognosis

Lung disease is the disease of the lung itself or lung manifestations of other diseases,including COPD,PTE,CAP,etc.In recent years,the incidence rate has been increased year after year.Many of these diseases have hidden onset and complicated causes.Therefore,accurate diagnosis and treatment are very important.Studies have shown that RDW is closely linked to the diagnosis and treatment of lung diseases.This article analyzes the research on RDW and lung diseases at home and abroad,and briefly summarizes the diagnosis,severity and clinical prognosis of lung diseases by RDW,hoping to provide useful clues and reliable basis for clinical workers,to provide assistance for further application research of RDW in lung diseases.

Heat Shock Protein 70 Gene Polymorphisms in Han Nationality of China with Chronic Obstructive Pulmonary Diseases

In order to investigate whether polymorphism in gene for heat shock protein 70 (HSP70) has any bearing on individual susceptibility to the development of chronic obstructive pulmonary disease(COPD), the geotypes of 88 patients with COPD and 87 healthy smoking control subjects were tested by polymerase chain reaction followed by restriction fragment polymorphism analysis for HSP70 gene. In COPD group, HSP70 1 genotype A/A, A/B and B/B was 59.1 %, 35.2 % and 5.7 %, HSP70 2 genotype A/A, A/B and B/B was 26.1 %, 54.6 % and 19.3 %, and HSP70 hom genotype A/A, A/B and B/B was 70.4 %, 27.3 % and 2.3 % respectively. In the control group, it was 60.9 %, 27.5 % and 3.5 %, 20.7 %, 56.3 % and 23.0 %, and 54.0 %, 42.5 % and 3.5 %, respectively. The frequency of polymorphic genetypes showed no difference between the COPD group and the control group ( P >0.05). It was suggested that geneic polymorphism in HSP70 is not associated with development of COPD in Han nationality of China.

Meta-analysis of the treatment of chronic obstructive pulmonary disease by tonifying lung and kidney

Objective:To A randomized controlled trial(RCTS)of lung tonifying and kidney tonifying in the treatment of chronic obstructive pulmonary disease(copd)by meta-analysis.Methods:Computer retrieval of databases such as CNKI、VIP、WanFang、Cochrane Library、EMbase、PubMed.The retrieval time was from the database construction to March 2020,and two evaluators were selected to screen the documents according to the na sorting standards,extract the data with Excel 2010 software,and perform Meta analysis with Rev Man5.3 software.Results:21 RCTS were included.Meta-analysis results show that compared with the conventional treatment,the method of supplementing lung and tonifying kidney can obviously improve lung function(MD=1.69,95%CI[1.36,2.01],P<0.00001)、reduce TCM syndrome score(MD=39.83,95%CI[18.10,61.56],P=0.0003)、improve life quality(MD=-5.90,95%CI[-8.95,-2.85],P=0.0001)、regulates serum immunoglobulin(MD=0.37,95%CI[0.31,0.44],P<0.00001)、improve 6MWD(MD=39.83,95%CI[18.10,61.56],P=0.0003)、improve CAT(MD=-1.68,95%CI[-2.05,-1.30],P<0.00001).The differences were statistically significant.For improved T lymphocyte subsets(MD=0.96,95%CI[-0.10,2.03],P=0.08)not statistically significant.Conclusion:Lung-tonifying kidney-tonifying method had better efficacy in improving lung function,reducing TCM syndrome score,improving quality of life,improving immunoglobulin,improving 6WMD,improving CAT,but the efficacy in improving t-lymphocyte subgroup was similar to that in the control group.Due to the limited quantity and quality of samples included in this paper,more multicenter randomized controlled trials with rigorous design of large samples should be carried out for verification.

Protective effect of sevoflurane on lung function of elderly chronic obstructive pulmonary disease patients undergoing total hip arthroplasty

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that affects the elderly population and increases the risk of postoperative pulmonary complications(PPCs)after major surgeries.Sevoflurane is a volatile anesthetic that has been shown to have anti-inflammatory and antioxidant properties and attenuate lung injury in animal models.AIM To evaluate the protective effect of sevoflurane on the lung function of elderly COPD patients undergoing total hip arthroplasty(THA).METHODS In this randomized controlled trial,we randomly assigned 120 elderly patients with COPD,who were scheduled for THA,to receive either sevoflurane(sevoflurane group)or propofol(propofol group)as the maintenance anesthetic.The primary outcome was the incidence of PPCs within seven days after surgery.The secondary outcomes were changes in the lung function parameters,inflammatory markers,oxidative stress markers,and postoperative pain scores.RESULTS The results showed that the incidence of PPCs was significantly lower in the sevoflurane group than in the propofol group(10%vs 25%,P=0.02).Furthermore,the decline in the forced expiratory volume in 1 s,forced vital capacity,and peak expiratory flow was significantly lesser in the sevoflurane group than in the propofol group at 24 h and 48 h after surgery(P<0.05).The interleukin-6,tumor necrosis factor-alpha,malondialdehyde,and 8-hydroxy-2α-deoxyguanosine levels were significantly lower in the sevoflurane group than in the propofol group at 24 h after surgery(P<0.05).The sevoflurane group showed significantly lower postoperative pain scores than the propofol group at 6 h,12 h,and 24 h after surgery(P<0.05).CONCLUSION Sevoflurane protects the lung function of elderly COPD patients undergoing THA under general anesthesia by reducing the incidence of PPCs,attenuating inflammatory and oxidative stress responses,and alleviating postoperative pain.

Efficacy Evaluation of Self-created"Lung Health Breathing Exercise"in Adjuvant Therapy for Patients with Stable Chronic Obstructive Pulmonary Disease

[Objectives]To evaluate the intervention effect and safety of self-created Lung Health Breathing Exercise on TCM syndromes,6-min walk test(6MWT)and quality of life in patients with stable chronic obstructive pulmonary disease(COPD).[Methods]76 cases of outpatient or inpatient patients who were diagnosed with stable COPD in Nanchong Traditional Chinese Medicine Hospital from January 2020 to March 2021 were selected,randomly divided into experimental group and control group,38 cases in each group.Both groups were given conventional western medicine treatment and nursing measures.The experimental group was added with the self-created Lung Health Breathing Exercise.After 12 weeks of treatment,the TCM syndrome score,6MWT distance,quality of life score and the incidence of adverse events were observed in the both groups.[Results]After treatment,the 6MWT distance and quality of life scores in both groups were significantly improved(P<0.01),and the TCM syndrome scores were significantly lower than those before treatment(P<0.01).[Conclusions]Lung Health Breathing Exercise can benefit patients in terms of symptom improvement,quality of life and exercise ability,and is a safe and effective rehabilitation measure for patients with stable COPD.

Predictive value of diaphragm ultrasound for mechanical ventilation outcome in patients with acute exacerbation of chronic obstructive pulmonary disease

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is often combined with respiratory failure,which increases the patient's morbidity and mortality.Diaphragm ultrasound(DUS)has developed rapidly in the field of critical care in recent years.Studies with DUS monitoring diaphragm-related rapid shallow breathing index have demonstrated important results in guiding intensive care unit patients out of the ventilator.Early prediction of the indications for withdrawal of non-invasive ventilator and early evaluation of patients to avoid or reduce disease progression are very important.AIM To explore the predictive value of DUS indexes for non-invasive ventilation outcome in patients with AECOPD.METHODS Ninety-four patients with AECOPD who received mechanical ventilation in our hospital from January 2022 to December 2023 were retrospectively analyzed,and they were divided into a successful ventilation group(68 cases)and a failed ventilation group(26 cases)according to the outcome of ventilation.The clinical data of patients with successful and failed noninvasive ventilation were compared,and the independent predictors of noninvasive ventilation outcomes in AECOPD patients were identified by multivariate logistic regression analysis.RESULTS There were no significant differences in gender,age,body mass index,complications,systolic pressure,heart rate,mean arterial pressure,respiratory rate,oxygen saturation,partial pressure of oxygen,oxygenation index,or time of inspiration between patients with successful and failed mechanical ventilation(P>0.05).The patients with successful noninvasive ventilation had shorter hospital stays and lower partial pressure of carbon dioxide(PaCO_(2))than those with failed treatment,while potential of hydrogen(pH),diaphragm thickening fraction(DTF),diaphragm activity,and diaphragm movement time were significantly higher than those with failed treatment(P<0.05).pH[odds ratio(OR)=0.005,P<0.05],PaCO_(2)(OR=0.430,P<0.05),and DTF(OR=0.570,P<0.05)were identified to be independent factors influencing the outcome of mechanical ventilation in AECOPD patients.CONCLUSION The DUS index DTF can better predict the outcome of non-invasive ventilation in AECOPD patients.

Professor Zhang Hongchun's medication rule in treating patients with stable chronic obstructive pulmonary diseases

Based on the Traditional Chinese Medicine Inheritance Support System(TCMISS),the medication rule of Professor Zhang Hongchun in treating patients with chronic obstructive pulmonary diseases(COPD)in stable period was carried out.The prescriptions of Professor Zhang Hongchun in treating COPD patients in stable period were collected and analyzed by frequency statistics,association rules and complex system entropy clustering.A total of 111 prescriptions were screened out,including 106 kinds of traditional Chinese medicine,which were mainly warm,cold and flat,and mainly sweet,bitter and pungent.The meridians were mostly attributed to lung,spleen,liver and kidney meridians.34 core combinations of drugs were extracted,and 38 association rules with confidence level of one were obtained.Three new prescriptions were obtained.The core prescriptions were:Angelicae Sinensis Radix(15g),Pseudostellariae Radix(30g),Cornus Officinalis Sieb Et Zucc(15g),Schisandrae Chinensis Fructus(15g),Farfarae Flos(15g),Asteris Radix Et Rhizoma(15g),Poria Cocos(Schw.)Wolf(15g),Perillae Fructus(15g),Perilla Frutescens(15g),Ephedra Herba(10g),Licorice(3g).Professor Zhang Hongchun's treatment methods of COPD patients in stable stage are to invigorate lung,spleen and kidney,and to stop cough,eliminate phlegm and asthma,promote Qi,activate blood circulation and dissipate blood stasis.

The Efficacy Analysis of Transbronchoscopic Large Volume Lung Lavage in Treatment of Pneumoconiosis Complicated with Chronic Obstructive Pulmonary Disease

Objective:To evaluate the efficacy of transbronchoscopic large volume lung lavage in the treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods:The clinical data of 80 patients with pneumoconiosis complicated with COPD admitted to our hospital from June 2017 to January 2019 were retrospectively analyzed.40 patients in the control group were treated with conventional drugs and 40 patients in the observation group treated with conventional drugs plus transbronchoscopic large-volume lung lavage.Dyspnea score and healthy quality of life were compared between the two groups.Results:the scores of dyspnea in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment,and the(SGRQ)scores of George’s respiratory problems questionnaire in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment.Conclusion:Thetransbronchoscopic large volume of lung lavage has a significant effect on the treatment of pneumoconiosis patients with COPD,which can effectively reduce the degree of dyspnea and improve the quality of life.

Acupoint selection rules for acupoint application in lung diseases in the post-epidemic era

Objective:To summarize the rules of acupoint selection of acupoint application to prevent and treat lung diseases under the background the post-epidemic era using data-mining technology.Method:The CNKI,Wanfang database,and VIP database were searched for clinical study articles on lung diseases treated by acupoint application published in the past 5 years.Data-eligible papers were extracted to establish a database of acupoint application for lung disease using Microsoft Excel 2019,with the goal of analyzing the frequency of acupoints,acupoint-meridian association,acupoint-location association,specific acupoint frequency,and cluster analysis.Association rules,consisting of acupoints with an application frequency of≥10,were devised by the Apriori algorithm to explore the correlation between acupoint groups and to analyze the rules of the compatibility of acupoint prescriptions.Results:A total of 229 eligible papers met our inclusion criteria.Forty-seven acupoints were applied,for a total frequency of acupoints of 1,035 times.Among these,acupoints for lung diseases were primarily distributed in the back-and-waist and chest-and-abdomen areas.From the analysis of the association rules,we obtained four groups of acupoint association rules based on acupoint clusters with a frequency≥10 and found that Feishu(BL 13),Tiantu(CV 22),Dazhui(GV 14),Dingchuan(EX-B1),and Danzhong(CV 17)constitute the core acupoints of prescriptions for clinical acupoint application to prevent and treat lung diseases.Conclusion:It is clearly shown that the core acupoints are relatively concentrated and that the selected acupoints were mainly locally selected,which could be a matching reference for the long-term prevention and treatment of lung diseases,including COVID-19.

Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease

Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature,absence of radiation exposure,widespread availability,prompt results,high accuracy,and repeatability at the bedside.The diaphragm is a crucial respiratory muscle.Decline or dysfunction of the diaphragm can lead to dyspnea and even respiratory failure in AECOPD patients.In this editorial,we comment on an article,retrospectively analyzed ninety-four acute exacerbations of chronic obstructive pulmonary disease patients who received mechanical ventilation from January 2022 to December 2023.The study found that the diaphragm thickening fraction,an index from diaphragm ultrasound,can better predict the outcome of non-invasive ventilation in patients with AECOPD.The value of non-invasive ventilation in treating respiratory failure caused by AECOPD has been widely acknowledged.Diaphragmatic dysfunction diagnosed with ultrasound is asso-ciated with prolonged mechanical ventilation and weaning times and higher mortality.

Expiratory Flow Limitation and Its Relation to Dyspnea and Lung Hyperinflation in Patients with Chronic Obstructive Pulmonary Disease: Analysis Using the Forced Expiratory Flow-Volume Curve and Critique

Background: Tidal expiratory flow limitation (tEFL) is defined as absence of increase in air flow during forced expiration compared to tidal breathing and is related to dyspnea at rest and minimal exertion in patients with chronic airflow limitation (CAL). Tidal EFL has not been expressed as a continuous variable (0% - 100%) in previous analyses. Objective: To relate the magnitude of tEFL to spirometric values and Modified Medical Research Council (MMRC) score and Asthma Control Test (ACT). Methods: Tidal EFL was computed as percent of the tidal volume (0% - 100%) spanned (intersected) by the forced expiratory-volume curve. Results: Of 353 patients screened, 192 (114 M, 78 F) patients (136 with COPD, 56 with asthma) had CAL. Overall characteristics: (mean ± SD) age 59 ± 11 years, BMI 28 ± 7, FVC (% pred) 85 ± 20, FEV1 (% pred) 66 ± 21, FEV1/FVC 55% ± 10%, RV (% pred) 147 ± 42. Tidal EFL in patients with tEFL was 53% ± 39%. Using univariate analysis, strongest correlations were between tEFL and FVC and between tEFL and RV in patients with BMI < 30 kg/m2. In patients with nonreversible CAL, tEFL was positively associated with increasing MMRC, negatively with spirometric measurements, and positively with RV/TLC. In asthmatics, ACT scores were higher in patients with mean BMI ≥ 28 kg/m2 (p < 0.00014) and RV/TLC values > 40% (p < 0.03). Conclusions: Dyspnea is strongly associated with tEFL and lung function, particularly in patients with nonreversible CAL. Air trapping and BMI contribute to tEFL.

Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is a serious complication of chronic obstructive pulmonary disease,often characterized by increased morbidity and mortality.In traditional Chinese medicine,AECOPD is linked to phlegm-heat and blood-stasis,presenting symptoms like thick sputum,fever,and chest pain.It has been shown that acetylcysteine inhalation in conjunction with conventional therapy significantly reduced inflammatory markers and improved lung function parameters in patients with AECOPD,suggesting that acetylcysteine may be an important adjunctive therapy for patients with phlegm-heat-blood stasis type AECOPD.AIM To investigate the effect of acetylcysteine on microinflammation and lung ventilation in patients with phlegm-heat and blood-stasis-type AECOPD.METHODS One hundred patients with phlegm-heat and blood-stasis-type AECOPD were randomly assigned to two groups.The treatment group received acetylcysteine inhalation(10%solution,5 mL,twice daily)along with conventional therapy,whereas the control group received only conventional therapy.The treatment duration was 14 d.Inflammatory markers(C-reactive protein,interleukin-6,and tumor necrosis factor-alpha)in the serum and sputum as well as lung function parameters(forced expiratory volume in one second,forced vital capacity,and peak expiratory flow)were assessed pre-and post-treatment.Acetylcysteine inhalation led to significant reductions in inflammatory markers and improvements in lung function parameters compared to those in the control group(P<0.05).This suggests that acetylcysteine could serve as an effective adjunct therapy for patients with phlegm-heat and blood-stasis-type AECOPD.RESULTS Acetylcysteine inhalation significantly reduced inflammatory markers in the serum and sputum and improved lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD compared with the control group.These differences were statistically significant(P<0.05).The study concluded that acetylcysteine inhalation had a positive effect on microinflammation and lung ventilation function in patients with this type of AECOPD,suggesting its potential as an adjuvant therapy for such cases.CONCLUSION Acetylcysteine inhalation demonstrated significant improvements in reducing inflammatory markers in the serum and sputum,as well as enhancing lung ventilation function parameters in patients with phlegm-heat and bloodstasis type AECOPD.These findings suggest that acetylcysteine could serve as a valuable adjuvant therapy for individuals with this specific type of AECOPD,offering benefits for managing microinflammation and optimizing lung function.

Chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease:Correlations with blood eosinophil level

Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level.

Application of "dredging meridians and dispersing lung exercises" based on meridian theory of traditional Chinese medicine in patients with stable chronic obstructive pulmonary disease

Objective:To investigate the effects of Tongjing xuanfei exercise on clinical symptoms,pulmonary function and exercise endurance of patients with Chronic obstructive pulmonary disease at stable stage.Methods:A total of 130 patients with Chronic obstructive pulmonary disease at stable stage from the Department of Pulmonary Diseases,Qingdao Haici Medical Group during September 2018 to September 2020 were collected and randomly divided into a observation group and a control group,with 65 patients in each group.The control group was given routine pulmonary rehabilitation nursing,and the observation group was given Tongjing Xuanfei exercise treatment combined with routine pulmonary rehabilitation nursing,12 months for treatment.The changes of symptoms and pulmonary function index were observed before and after treatment.Results:FEV1,FVC,FEV1%pred,FEV1/FVC,exercise endurance and CAT score,mMRC dyspnea index score and TCM clinical symptom score in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Tongjing Xuanfei exercise is helpful to improve the clinical symptoms,pulmonary function and exercise endurance of patients with Chronic obstructive pulmonary disease at stable stage.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

Chronic obstructive pulmonary disease as a risk factor for lung cancer

The association between chronic obstructive pulmonary disease(COPD) and lung cancer has long been a subject of intense debate. The high prevalence of COPD in elderly smokers inevitably strengthens their coincidence. In addition to this contingent coincidence, recent studies have revealed a close association between the two diseases that is independent of the smoking history; that is, the existence of COPD is an independent risk factor for the development of lung cancer. Molecular-based evidence has been accumulating as a result of the efforts to explain the underlying mechanisms of this association. These mechanisms may include the following: the retention of airborne carcinogens followed by the activation of oncogenes and the suppression of tumor suppressor genes; the complex molecular mechanism associated with chronic inflammation in the distal airways of patients with COPD; the possible in-volvement of putative distal airway stem cells; and gel netic factors that are common to both COPD and lung cancer. The existence of COPD in patients with lung l cancer may potentially affect the process of diagnosis, surgical resection, radiotherapy, chemotherapy, and end-of-life care. The comprehensive management of COPD is extremely important for the appropriate treatment of lung cancer. Surgical resections with the aid of early interventions for COPD are often possible, even for patients with mild-to-moderate COPD. New challenges, such as lung cancer CT screening for individuals t at high risk, are now in the process of being implemented. Evaluating the risk of lung cancer in patients with COPD may be warranted in community-based lung cancer screening.

The effect of traditional Chinese medicine rehabilitation exercise(pulmonary Daoyin)in patients with chronic obstructive pulmonary disease:A systematic review and meta-analysis

Objective:Previous research has demonstrated that pulmonary Daoyin could be an efficacious way to ameliorate the physical and psychological state of sufferers with chronic obstructive pulmonary disease(COPD)and bolster the quality of life.However,the results are not consistent.Thus,the objective of this research is to assess the impacts of pulmonary Daoyin in individuals with COPD.Methods:Relevant articles were searched in Web of Science,Cochrane Library,PubMed,EMBASE,SinoMed,CNKI,Wanfang,and VIP from database inception to January 2024.Results:There were a total of 15 randomized controlled trials(RCTs)included in this meta-analysis involving 1732 patients,of which 864 participated in the intervention group and 868 in the control group.When comparing with the control group,the COPD patients practicing pulmonary Daoyin demonstrated a significant improvement in 6 min walking distance(mean difference[MD]=24.53,95%confidence interval[CI][18.55,30.52],P<0.00001),forced expiratory volume in the 1 s(FEV_(1))(MD=0.39,95%CI[0.18,0.59],P=0.0002),percentage of FEV_(1)to the predicted value(FEV_(1)%)(MD=5.35,95%CI[3.22,7.48],P<0.0001),the forced vital capacity(FVC)(MD=0.39,95%CI[0.06,0.73],P=0.02),percentage of FVC to the predicted value(FVC%)(MD=7.52,95%CI[4.91,10.13],P<0.00001),the ratio of FEV_(1)/FVC(MD=4.95,95%CI[0.91,8.99],P=0.02),peak expiratory flow rate(standardized MD=0.98,95%CI[0.74,1.22],P<0.00001),modified Medical Research Council(mMRC)scale(MD=-0.47,95%CI[-0.89,-0.04],P=0.03),and Borg scale(MD=-0.65,95%CI[-0.75,-0.55],P<0.00001).Conclusions:Our findings may illuminate the influence of pulmonary Daoyin on exercise ability,breathlessness,and pulmonary function in COPD patients.More rigorous RCTs with larger samples and longer-term interventions will be required moving forward.